Prior authorization (PA) is the boss level of the Eligibility & Benefits domain, the giant locked door that stands between you and getting paid. This week, Jeremy is diving deep into the controversial world of prior authorizations, debunking the persistent myth of the “retro auth” and breaking down exactly how to conquer this gatekeeper of revenue.
We walk you through the three crucial hurdles: Identification, ensuring you know the requirements before the patient walks in; Request, mastering the art of over-communicating medical necessity to avoid the “delay loop” ; and the Outcome—including how to sidestep the exhausting peer-to-peer review trap.
We also zoom out to the massive national conversation happening right now—patient access vs. cost containment—and discuss the “gold carding” trend that could revolutionize how good providers play the game. Learn the two essential tools you need to turn PA chaos into efficiency and ensure your hard work translates into deposits, not denials.
It’s time to build a bulletproof process and win The Claim Game as it’s played today.
